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Multifocal intraocular lenses (MIOL) are special artificial lenses to correct long-sightedness, short-sightedness, presbyopia and astigmatism. The implantation of multifocal intraocular lenses is carried out as part of a so-called refractive lens exchange.

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Multifocal intraocular lenses - Further information

What are multifocal intraocular lenses (MIOL)?

Would you like to wake up in the morning and see clearly without glasses or contact lenses? The implantation of multifocal intraocular lenses (MIOL) is a surgical procedure to correct long-sightedness, short-sightedness and presbyopia. Astigmatism can also be successfully corrected with multifocal intraocular lenses.

In this procedure, doctors remove the body's own lens and replace it with a multifocal intraocular lens. This procedure is similar to cataract surgery, the most common surgical procedure in eye surgery. As the multifocal intraocular lens corrects distance and near vision, you no longer need glasses in everyday life.

Multifokale Intraokularlinsen (MIOL)A multifocal intraocular lens makes sharp vision possible without glasses @ Oktay /AdobeStock

Preliminary examinations before the implantation of multifocal intraocular lenses

The doctor and specially trained technical staff will examine your eyes in detail before implantation. The painless examinations take around two to three hours.

The preliminary examinations include

  • Measurement of visual acuity
  • Determination of the intraocular pressure
  • Determination of the corneal topography
In addition, the doctor measures the eye to calculate the power of the multifocal intraocular lens. Depending on the degree of astigmatism, special toric artificial lenses are used. Discuss the advantages and disadvantages of the various options with your doctor.
Further examinations with a slit lamp and magnifying glass also provide information as to whether the implantation of multifocal intraocular lenses is possible. Which procedure makes sense is also part of the examination.
In addition, the extent to which vision improves with multifocal intraocular lenses can usually be determined during the preliminary examination.
After the examinations, the doctor can then be certain whether the implantation of multifocal intraocular lenses is advisable.
If there are no other eye diseases and if the implantation improves vision, then nothing stands in the way of the treatment.

Procedure for the implantation of multifocal intraocular lenses

After you have eaten at home as usual, you will come to the clinic at the agreed time. When you arrive, you will be taken to the operating department. Assistants will prepare you for the implantation of the multifocal intraocular lenses and carry out some routine examinations (blood pressure measurement, ECG). You will then be given eye drops.

  • Anesthesia for the implantation of multifocal intraocular lenses

The implantation of multifocal intraocular lenses takes place under local anesthesia. This means that you are conscious but do not feel any pain.

In most cases, special eye drops are sufficient to anaesthetize you. You will not feel any pain during the operation. An anesthesiologist will take care of you during the procedure.

  • Operation to implant multifocal intraocular lenses
The implantation of multifocal intraocular lenses involves several stages.
First, the doctor removes the lens material. The treatment procedure is called phacoemulsification: the doctor inserts a tiny hollow knife into the eye. The access is about 2 mm in size.
The tip vibrates at a frequency of 40,000 vibrations per second. It uses ultrasound energy to break up the lens tissue to such an extent that it can be aspirated through the opening. The lens capsule normally remains in the eye. It serves as a "pocket" for the new multifocal intraocular lens.
The insertion of the artificial multifocal intraocular lens is always part of the operation. First, doctors clean the lens pocket. To avoid having to widen the incision, doctors insert the multifocal intraocular lens in a rolled state. The small incision usually allows the wound to be closed without sutures. As a rule, there is no image distortion.
The multifocal intraocular lens remains permanently in the eye from then on .

It cannot be ruled out that you will need glasses for computer work or for very small print. In principle, the multifocal intraocular lens has no near adaptation capability.

The surgical steps involved in implanting multifocal intraocular lenses:

  1. Doctors open the lens capsule through a small incision at the edge of the cornea.
  2. They then cut up and remove the lens parts using an ultrasound probe.
  3. They insert the multifocal intraocular lens.
  4. The implantation of the new multifocal intraocular lens is completed. The elastic lens stirrups stabilize it in the remaining capsular bag.

multifokale Intraokularlinsen

  • Medication for the implantation of multifocal intraocular lenses

You should behave as usual before the operation. Do not change your diet or therapy and take your medication as usual.

If you are taking Marcumar or other anticoagulants, please consult your family doctor.

After the implantation of multifocal intraocular lenses, you must take antibiotic eye drops. Your doctor will discuss with you how often and for how long you will need them.

Complications and risks associated with the implantation of multifocal intraocular lenses

Multifocal intraocular lenses can result in the following complications:

  • Infections of the eye with the possibility of severe and most severe impairment up to loss of vision of the eye
  • Increased sensitivity to light and glare, possibly permanently
  • Reduced night vision, possibly permanently
  • Over- or undercorrection with the need for further surgery or corrective lenses
  • Change in spatial vision, which can lead to impaired orientation, e.g. when driving
  • After the operation, you may need reading glasses for small print texts or on the computer

Follow-up treatment after implantation of multifocal intraocular lenses

The first check-up will always take place in the clinic the day after the operation. The doctor will tell you how to use the eye drops, which you will instill for four weeks. He will also explain to you when you should wear protective goggles.

In the first few days, you will often experience itching or scratching. You will also experience some blurred vision, especially after the multifocal intraocular lenses have been implanted. This is normal as the pupil is still dilated. Neither watching television nor reading will harm your eyes.
One to two days after implantation of the multifocal intraocular lenses, patients often achieve quite good visual acuity. You can only drive again once the doctor has given you the green light.
The check-ups take place one week and one month after the procedure, the final examination after 2 to 3 months. The routine eye examinations take place later.

Conclusion on multifocal intraocular lenses

The implantation of multifocal intraocular lenses is very safe and precise thanks to modern surgical technology. The risks are minimal. After the implantation of multifocal intraocular lenses , cataracts can no longer occur. The strength for reading glasses remains the same. This is how you correct your defective vision.
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